Learning Curves for Electromagnetic Navigation Bronchoscopy Using CUSUM Analysis.
Journal
Journal of bronchology & interventional pulmonology
ISSN: 1948-8270
Titre abrégé: J Bronchology Interv Pulmonol
Pays: United States
ID NLM: 101496866
Informations de publication
Date de publication:
01 Jul 2022
01 Jul 2022
Historique:
received:
29
04
2021
accepted:
31
08
2021
pubmed:
26
9
2021
medline:
24
6
2022
entrez:
25
9
2021
Statut:
ppublish
Résumé
Electromagnetic navigation bronchoscopy (ENB) is a relatively new and technically demanding procedure for the guidance of bronchoscopic biopsy to help locate small lung lesions. The results in experienced hands are well described. However, we do not know the results in unexperienced hands-in other words, we have no knowledge about how fast you can learn the procedure. The aim of this study was to draw learning curves for beginners in ENB using Cumulated Sum (CUSUM) analysis, a method for quantitative evaluation of the learning curves for clinical procedures. Four operators from 3 centers without prior ENB experience were enrolled. The outcome of consecutive ENB procedures was assessed and classified as either diagnostic or nondiagnostic based on sample adequacy. Learning curves were drawn based on diagnostic yield. A total of 215 procedures were assessed. For 2 of the operators (operators 1 and 4), at least 25 to 30 procedures were necessary to obtain competency whereas operators 2 and 3 showed more horizontal learning curves indicating an overweight of diagnostic procedures from the beginning. Operators achieve competences in ENB at different paces. This must be taken in account when beginners start to learn the procedure. There is a huge need for a structured educational program and a validated test to determine competences.
Sections du résumé
BACKGROUND
BACKGROUND
Electromagnetic navigation bronchoscopy (ENB) is a relatively new and technically demanding procedure for the guidance of bronchoscopic biopsy to help locate small lung lesions. The results in experienced hands are well described. However, we do not know the results in unexperienced hands-in other words, we have no knowledge about how fast you can learn the procedure.
AIM
OBJECTIVE
The aim of this study was to draw learning curves for beginners in ENB using Cumulated Sum (CUSUM) analysis, a method for quantitative evaluation of the learning curves for clinical procedures.
METHODS
METHODS
Four operators from 3 centers without prior ENB experience were enrolled. The outcome of consecutive ENB procedures was assessed and classified as either diagnostic or nondiagnostic based on sample adequacy. Learning curves were drawn based on diagnostic yield.
RESULTS
RESULTS
A total of 215 procedures were assessed. For 2 of the operators (operators 1 and 4), at least 25 to 30 procedures were necessary to obtain competency whereas operators 2 and 3 showed more horizontal learning curves indicating an overweight of diagnostic procedures from the beginning.
CONCLUSION
CONCLUSIONS
Operators achieve competences in ENB at different paces. This must be taken in account when beginners start to learn the procedure. There is a huge need for a structured educational program and a validated test to determine competences.
Identifiants
pubmed: 34561367
doi: 10.1097/LBR.0000000000000815
pii: 01436970-202207000-00003
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
164-170Informations de copyright
Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
Disclosure: There is no conflict of interest or other disclosures.
Références
Schwarz Y, Greif J, Becker HD, et al. Real-time electromagnetic navigation bronchoscopy to peripheral lung lesions using overlaid CT images: the first human study. Chest. 2006;129:988–994.
Heerink WJ, Bock GH, de, Jonge GJ, et al. Complication rates of CT-guided transthoracic lung biopsy: meta-analysis. Eur Radiol. 2017;27:138–148.
Farr A, Clementsen P, Herth F, et al. Endobronchial ultrasound: launch of an ERS structured training programme. Breathe. 2016;12:217–220.
Young A, Miller JP, Azarow K. Establishing learning curves for surgical residents using Cumulative Summation (CUSUM) Analysis. Curr Surg. 2005;62:330–334.
Kestin IG. A statistical approach to measuring the competence of anaesthetic trainees at practical procedures. Br J Anaesth. 2017;75:805–809.
Bolsin S, Colson M. The use of the Cusum technique in the assessment of trainee competence in new procedures. Int J Qual Health Care. 2000;12:433–438.
Zhang W, Chen S, Dong X, et al. Meta-analysis of the diagnostic yield and safety of electromagnetic navigation bronchoscopy for lung nodules. J Thorac Dis. 2015;7:799–809.
Kemp SV, Batrawy SHE, Harrison RN, et al. Learning curves for endobronchial ultrasound using cusum analysis. Thorax. 2010;65:534.
Sun J, Xie F, Zheng X, et al. Learning curve of electromagnetic navigation bronchoscopy for diagnosing peripheral pulmonary nodules in a single institution. Transl Cancer Res. 2017;6:541–551.
Liebman DL, McKay KM, Haviland MJ, et al. Quantifying the educational benefit of additional cataract surgery cases in ophthalmology residency. J Cataract Refract Surg. 2020;46:1495–1500.
Ali HM, Taha MY, Aswa ARA, et al. Learning curve for spinal anesthesia as a basic skill in the training program of the anesthesia resident in Faculty of Medicine, Cairo University. Egypt J Anaesth. 2020;36:112–117.
Eva KW, Cunnington JPW, Reiter HI, et al. How can I know what I don’t know? poor self assessment in a well-defined domain. Adv Health Sci Educ Theory Pract. 2004;9:211–224.
Memoli JSW, Nietert PJ, Silvestri GA. Meta-analysis of guided bronchoscopy for the evaluation of the pulmonary nodule. Chest. 2012;142:385–393.
Folch EE, Pritchett MA, Nead MA, et al. Electromagnetic navigation bronchoscopy for peripheral pulmonary lesions: one-year results of the prospective, multicenter NAVIGATE Study. J Thorac Oncol. 2019;14:445–458.